We carried out this announced inspection on 12 October 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We told NHS England and Healthwatch that we were inspecting the practice. They did not provide any information of concern.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Worthing Dental Practice is located in Worthing. It provides NHS and private treatment to patients of all ages.

The practice is located on two floors. There are three treatment rooms including a wheelchair accessible treatment room on the ground floor and a decontamination room. There is a separate reception and patient waiting room.

The dental team includes the principal dentist, one hygienist, one qualified dental nurse, one trainee dental nurse, two receptionists and a practice manager.

The practice is owned by an individual who is the principal dentist. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

During the inspection we spoke with the principal dentist, two dental nurses, one receptionist and a practice manager. We looked at practice policies and procedures and other records about how the service is managed.

On the day of inspection we collected 36 CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

The practice is open: Monday to Thursday from 9am to 5.30pm and Friday from 9am to 1pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt supported.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

We found areas where the provider could make improvements and should:

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s systems for analysing the results of audits and reviews to identify, share and act on areas for improvement where appropriate.

We spoke to three patients who were attending with their families. Everyone told us they were very satisfied with the care they had received and commented that staff were “kind and helpful” and it is always “clean and hygienic”. ”Our children like coming here and they get stickers”.

All patients updated their medical histories and all patient records were paper based. The dentist explained that patients made their next appointment based upon a risk assessment made by the dentist which followed recommended guidelines. This meant that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

There were effective systems in place to reduce the risk and spread of infection. Audit on infection control were completed every three months. The latest audit showed the practice had achieved between a 95-100% score overall in compliance.

We were shown certificates of training which provided evidence that staff would achieve the level of continuing professional development (CPD) required to remain registered with the GDC. We observed that staff received appropriate professional development.

We saw that staff files were kept up to date by individual staff members. Staff records and other records relevant to the management of the services were accurate and fit for purpose.